Provider Demographics
NPI:1902246226
Name:SCALERA, JOEL C (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:C
Last Name:SCALERA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 WILD PINE LN
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-6218
Mailing Address - Country:US
Mailing Address - Phone:321-259-3283
Mailing Address - Fax:
Practice Address - Street 1:33 SUNTREE PL
Practice Address - Street 2:SUITE A
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7602
Practice Address - Country:US
Practice Address - Phone:321-259-3283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10620122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist